[Minor anal pathology. Suggestions for ambulatory and hospital treatment]

A series of cases of anorectal pathology treated at the out-patient level or after hospitalisation in the course of the last five years is reviewed. Deference is made to subjects with haemorrhoids operated according to Milligan-Morgan or Parks in accordance with varying indications, or treated cryosurgically as out-patients, patients with upper or lower transsphincteric perianal fistula treated by means of the lay-open technique or elastic tourniquet under general or local anaesthesia, patients with acute anal fissures treated by means of internal lateral sphincterotomy under local anaesthesia, and those with inveterate forms subjected to Arnous posterior leiomyotomy. From a critical assessment of the hospital and out-patient activities carried out suggestions and indications are drawn with regard to cases that must be treated in hospital and those for which outpatient management is correct.

[Hemorrhoid pathology in the young]

Although haemorrhoids have been known for centuries, there is still some controversy on the subject. In addition little attention has so far been paid to their appearance in young people. The incidence and aetiopathogenesis of the condition and the correct therapeutic approach are discussed on the basis of personal experience, clinical research and recent additions to the sparse literature on the subject.

[Cryogenic treatment of rectal tumors]

10 patients with anal or rectal cancers were given liquid nitrogen cryogenic treatment. In 5 cases the treatment was given prior to abdominoperineal amputation of the rectum. The remaining 5 inoperable cases were given the cryogenic treatment alone, followed, in 3 cases by derivative colostomy. Histological reports on the removed tissues, carried out at different times after the cryogenic treatment, showed the effects of the treatment on the neoplasias and the surrounding tissues and showed the histological equivalent of possible local immunological processes. The thrombosis in the surrounding blood vessels appears to indicate the efficacity of cryogenic therapy in preventing the metastasis of neoplastic cells.

Analysis of variance applied to determinations of equilibrium constants

The statistical analysis of variance has been applied to the values of the equilibrium constants of the glycinate-proton and glycinate-nickel systems, determined in different laboratories by pH-titration in aqueous solution. The analysis shows how the main part of the error derives from the variability from one titration to another even in the same laboratory. Therefore the data for a single titration (k) must be processed separately, thus yielding a mean value for the equilibrium constant logbeta (pqr)(k) of the species M(p)H(q)L(r); from these mean values for different titrations in each laboratory l, a within-laboratory grand average, logbeta (pqr)(l), can be calculated; the variance of this grand average measures the experimental error. A further analysis of the data from the different participating laboratories shows that there were no significant differences between laboratories for the constants reported. From these results it can be inferred that all the values of the mean constants logbeta (pqr)(k) for one species, as determined separately for each titration in four laboratories, belong to the same population. A chi(2) analysis of these populations demonstrates that the stability constants of the species HL, H(2)L(+), NiL(+), NiL(2) (with L(-) = glycinate) are normally distributed, but not that for NiL(-)(3). Therefore, general mean values of the first four constants can be calculated and proposed as reliable standard values at 25 degrees and I = 1.0M Na(Cl): protonation of glycinate, log beta(011) = 9.651(12), log beta(021) = 12.071(26); nickel-glycinate complexes, log beta(101) = 5.615(35), log beta(102) = 10.363(62). These values indicate that the standard deviations are rather higher than those often reported in the literature.

[Treatment of peri-anal fistulas. A current problem]

This problem of the treatment of perianal fistulas is examined and current principles of correct, effective therapeutic conduct set out. The techniques available vary with the type of fistula and the school of proctology. The as yet controversial point revolves about the way and the extent of possible sphincteric section. 80 cases reported provide a basis for some practical considerations.

[Notes on cryosurgery in proctology]

The A. in a review of the outpatient proctologic practice suggest the application of the crioprobe to the piles first and second degree, and to polyps small ones. A pathogenetic hypothesis of this narrowing application is supported on the basis of the unpractible mucosa, affected by 3rd degree piles. Furthermore the N2O employment seems to be unusefull in the treatment of the polyps and a further improvement of the probes is required.

Ultrastructural and biochemical studies on a case of elastosis perforans serpiginosa

Ultrastructural and biochemical studies on the collagen and elastin fibres of the dermis from a patient with Elastosis perforans serpiginosa are described. Qualitative and quantitative alterations on collagen and elastin are shown, which give some evidence for considering the disease as a connective tissue defect.

[The role of lumbar sympathectomy. Review of the cases performed between 1950 and 1955 (author's transl)]

This reviews 839 isolated lumbar sympathectomy performed between 1950 and 1975. The patients are stratified by decades and grouped in 3 periods : 1950 to 1959, 1960 to 1969 and 1970 to 1975. In the first period most patients were between 50 and 59 years old; in the last period most were between 60 and 69 years old. At this time direct vascular reconstruction had become more frequent. The approach described by Pearls was used exclusively in the last period. Isolated lumbar sympathectomy yields a symptomatic improvement. Best results are obtined in peripheral and isolated lesions.